Figures (5)  Tables (4)

    • Figure 1. 

      Serum levels of ACSL4 and other biomarkers in colorectal cancer patients.

    • Figure 2. 

      Association of serum ACSL4 and other biomarkers with PNI.

    • Figure 3. 

      Scatterplot of serum ACSL4 and PNI (Spearman's ρ = 0.193, p = 0.004)

    • Figure 4. 

      ROC curves for prognosis in colorectal cancer patients. ROC curve for patients with poor prognosis: (a) ACSL4: AUC = 0.750, 95% CI 0.679–0.821; (b) PNI: AUC = 0.712, 95% CI: 0.639–0.784; (c) combine ACSL4 and PNI: AUC = 0.811, 95% CI 0.751–0.871.

    • Figure 5. 

      Kaplan–Meier survival curves stratified by serum ACSL4 levels in CRC patients.

    • Variable Poor prognosis
      group, n = 53      		 Favorable prognosis
      group, n = 162      		 p
      Age (year) 58 (44–72) 55 (42–69) 0.020
      Sex, female (%) 21 (39.6) 69 (42.6) 0.666
      BMI 21.73 ± 2.69 21.29 ± 2.93 0.332
      TNM stage < 0.001
      I-II, n (%) 22 (41.5) 128 (79.0)
      III, n (%) 31 (58.5) 34 (21.0)
      Tumour diameter (cm) 7.02 ± 1.36 4.69 ± 1.05 < 0.001
      ALB (g/L) 35.63 ± 3.04 37.58 ± 3.72 0.001
      BL (109/L) 1.68 ± 0.40 1.95 ± 0.63 0.003
      TC (mmol/L) 3.41 ± 0.52 3.39 ± 0.47 0.756
      TG (mmol/L) 1.33 ± 0.15 1.35 ± 0.14 0.420
      LDLC (mmol/L) 2.85 ± 0.27 2.83 ± 0.30 0.724
      HDLC (mmol/L) 1.10 ± 0.17 1.08 ± 0.18 0.448
      PNI 43.99 ± 3.35 47.35 ± 4.85 < 0.001
      Tumor location 0.340
      Right-sided colon 11 (20.8) 40 (24.7)
      Left-sided colon 14 (26.4) 55 (34.0)
      Rectum 28 (52.8) 67 (41.4)
      Differentiation grade 0.072
      Well/moderate 37 (69.8) 132 (81.5)
      Poor 16 (30.2) 30 (18.5)
      Lymphovascular invasion 0.002
      No 30 (56.6) 127 (78.4)
      Yes 23 (43.4) 35 (21.6)
      Perineural invasion 0.013
      No 37 (69.8) 138 (85.2)
      Yes 16 (30.2) 24 (14.8)
      Adjuvant chemotherapy 0.436
      No 20 (37.7) 71 (43.8)
      Yes 33 (62.3) 91 (56.2)
      Surgical approach 0.728
      Open surgery 13 (24.5) 36 (22.2)
      Laparoscopic surgery 40 (75.5) 126 (77.8)
      Margin status 0.420
      R0 51 (96.2) 159 (98.1)
      R1/R2 2 (3.8) 3 (1.9)
      ALB: albumin, BL: blood lymphocyte count, TC: total cholesterol, TG: triglyceride, LDLC: low-density lipoprotein cholesterol, HDLC: high-density lipoprotein cholesterol, PNI: prognostic nutritional index, BMI: body mass index, TNM: tumor-node-metastasis.

      Table 1. 

      Demographic and clinical data of all subjects.

    • Variable ACSL4 (ng/mL)
      Spearman' ρ p
      IL-1β (pg/mL) −0.049 0.475
      IL-6 (pg/mL) 0.036 0.595
      CRP (pg/mL) −0.074 0.282
      CEA (ng/mL) −0.330 < 0.001
      CA199 (U/mL) −0.244 < 0.001
      ACSL4: acyl-CoA synthetase long-chain family member 4, IL-1β: interleukin-1 beta, IL-6: interleukin-6, CRP: C-reactive protein, CEA: carcinoembryonic antigen, CA199: carbohydrate antigen 19-9.

      Table 2. 

      Correlation analysis between ACSL4 and other biomarkers.

    • Model Variables included AUC 95% CI
      Base model TNM stage + tumour diameter + lymphovascular invasion 0.941 0.909–0.972
      Base model + PNI TNM stage + tumour diameter + lymphovascular invasion + PNI 0.953 0.928–0.978
      Base model + PNI + ACSL4 TNM stage + tumour diameter + lymphovascular invasion + PNI + ACSL4 0.964 0.942–0.986
      AUC, area under the receiver operating characteristic curve; CI, confidence interval; PNI, prognostic nutritional index; ACSL4, acyl-CoA synthetase long-chain family member 4; CEA, carcinoembryonic antigen; TNM, tumor-node-metastasis.

      Table 3. 

      Incremental AUC of clinicopathologic model with PNI and ACSL4.

    • Variables Wald Odds ratio 95% CI p
      TNM stage 11.854 8.298 2.487–27.688 0.001
      Tumour diameter (cm) 31.138 5.617 3.064–10.299 < 0.001
      PNI 4.209 0.880 0.779–0.994 0.040
      ACSL4 (ng/mL) 9.649 0.736 0.606–0.893 0.002
      Lymphovascular invasion 1.787 2.219 0.690–7.137 0.181
      PNI: prognostic nutritional index, ACSL4: acyl-CoA synthetase long-chain family member 4.

      Table 4. 

      Logistic regression for risk factors of poor prognosis in CRC patients.